BUNNEL LITTLER

TEST

​​• Test positioning

The client sits with the metacarpophalangeal joint of the involved digit in slight extension.

​• Action

The therapist passively flexes the proximal interphalangeal joint of the same ray and assesses the amount of proximal interphalangeal joint flexion.

The therapist then passively flexes the metacarpophalangeal joint slightly, and again assesses the amount of flexion at the proximal interphalangeal joint.

​• Positive finding

A positive finding is revealed if the proximal interphalangeal joint does not flex while the metacarpophalangeal joint is in an extended position.

If the proximal interphalangeal joint does fully flex once the metacarpophalangeal joint is slightly flexed, intrinsic muscle tightness can be assumed.

By contrast, if flexion of the proximal interphalangeal joint remains limited once the metacarpophalangeal joint is slightly flexed, capsular tightness can be assumed.

​• Special considerations & comments

Care should be taken by the therapist to retain extension and then flexion of the metacarpophalangeal joint, while also testing in each position to assess true proximal interphalangeal joint motion.